What are the symptoms of allergic rhinitis?

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Last updated: April 27, 2025View editorial policy

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From the Guidelines

Allergic rhinitis symptoms include nasal congestion, runny nose with clear discharge, sneezing, itchy nose, and postnasal drip, as noted in the clinical practice guideline: allergic rhinitis 1.

Key Symptoms

  • Nasal congestion
  • Runny nose with clear discharge
  • Sneezing
  • Itchy nose
  • Postnasal drip Patients often experience itchy, watery, or red eyes, along with an itchy throat or ears, as well as facial pressure, headaches, fatigue, and decreased sense of smell, which are common symptoms of allergic rhinitis 1.

Associated Symptoms

  • Itchy, watery, or red eyes
  • Itchy throat or ears
  • Facial pressure
  • Headaches
  • Fatigue
  • Decreased sense of smell These symptoms occur when allergens like pollen, dust mites, pet dander, or mold trigger an immune response, causing the body to release histamine and other inflammatory chemicals, as explained in the clinical practice guideline: allergic rhinitis executive summary 1.

Allergen-Triggered Response

  • Allergens trigger an immune response
  • Release of histamine and other inflammatory chemicals
  • Inflammation of the nasal passages Symptoms may be seasonal (occurring during specific pollen seasons) or perennial (year-round), and some patients also experience a condition called "allergic shiners" - dark circles under the eyes caused by congested blood vessels, as noted in the clinical practice guideline: allergic rhinitis 1.

Seasonal and Perennial Symptoms

  • Seasonal symptoms: occur during specific pollen seasons
  • Perennial symptoms: occur year-round
  • Allergic shiners: dark circles under the eyes caused by congested blood vessels Mouth breathing due to nasal congestion can lead to dry mouth, throat irritation, and potentially disrupt sleep, and if these symptoms interfere with daily activities or sleep, medical evaluation is recommended as treatments like antihistamines, nasal corticosteroids, or allergen avoidance strategies can provide significant relief, as recommended in the clinical practice guideline: allergic rhinitis executive summary 1.

Treatment Options

  • Antihistamines
  • Nasal corticosteroids
  • Allergen avoidance strategies The most effective treatment for allergic rhinitis is intranasal corticosteroids, which can reduce symptoms of sneezing, itching, rhinorrhea, and nasal congestion, as recommended in the clinical practice guideline: allergic rhinitis executive summary 1.

From the FDA Drug Label

Temporarily relieves these symptoms due to hay fever or other upper respiratory allergies runny nose sneezing itchy, watery eyes itching of the nose or throat Temporarily relieves these symptoms due to hay fever or other upper respiratory allergies: • runny nose • itchy, watery eyes • sneezing • itching of the nose or throat

The symptoms of allergic rhinitis include:

  • Runny nose
  • Sneezing
  • Itchy, watery eyes
  • Itching of the nose or throat 2 3

From the Research

Symptoms of Allergic Rhinitis

  • The symptoms of allergic rhinitis include nasal congestion, rhinorrhea, postnasal drainage, sneezing, and itching of the eyes, nose, and throat 4
  • In an international study, the most common symptoms of allergic rhinitis were rhinorrhea (90.38%) and nasal congestion (94.23%) 4
  • Patients with seasonal allergic rhinitis typically have physical examination findings of edematous and pale turbinates, while patients with perennial allergic rhinitis typically have erythematous and inflamed turbinates with serous secretions 4
  • Allergic rhinitis is often associated with conjunctivitis and asthma, significantly impacting quality of life 5

Classification of Allergic Rhinitis

  • Intermittent allergic rhinitis is defined as symptoms occurring less than 4 consecutive days/week or less than 4 consecutive weeks/year 4
  • Persistent allergic rhinitis is defined as symptoms occurring more often than 4 consecutive days/week and for more than 4 consecutive weeks/year 4

Treatment of Allergic Rhinitis

  • First-line treatment for mild intermittent or mild persistent allergic rhinitis may include a second-generation H1 antihistamine or an intranasal antihistamine 4
  • Patients with persistent moderate to severe allergic rhinitis should be treated initially with an intranasal corticosteroid either alone or in combination with an intranasal antihistamine 4, 6
  • Combinations of medications in a single intranasal spray have shown greater efficacy in treating allergic rhinitis 5
  • Immunotherapy is effective in severe cases of allergic rhinitis, if tailored to the causing allergen 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Allergic rhinitis.

Medicina clinica, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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